Gynecology and Obstetrics Online Doctors Consultation — page 15

Hello Shreya, Certainly! Below is the prescription in a format commonly used in medical colleges and by healthcare professionals: **PRESCRIPTION** *Patient's Name:* Shreya *Age:* *Gender:* [Female] *Date:* 12/0425 *Diagnosis:* Fibroadenoma Bilateral, Pain, Migraine --- **1. Pain Management** - **Ibuprofen 400 mg Tablets** *Sig:* Take 1 tablet orally every 8 hours as needed for pain relief. Do not exceed 1200 mg per day. *Quantity:* 30 tablets *Refills:* 1 - **Paracetamol 500 mg Tablets** *Sig:* Take 1-2 tablets every 4-6 hours as needed for pain. Do not exceed 4 grams per day. *Quantity:* 30 tablets *Refills:* 1 **2. Hormonal Regulation (For Fibroadenoma)** - **Primosa (Evening Primrose Oil) 1000 mg Softgel** *Sig:* Take 1 softgel daily after a meal. *Quantity:* 30 softgels *Refills:* 1 --- - **Vitamin E 400 IU Capsules** *Sig:* Take 1 capsule daily. *Quantity:* 30 capsules *Refills:* 1 **3. Migraine Management** - **Sumatriptan 50 mg Tablets** *Sig:* Take 1 tablet at the onset of a migraine. If no relief, may repeat dose after 2 hours. Do not exceed 200 mg in 24 hours. *Quantity:* 6 tablets *Refills:* 1 **4. Preventive Care and Support** - **Magnesium 400 mg Tablets** *Sig:* Take 1 tablet daily for migraine prevention. *Quantity:* 30 tablets *Refills:* 1 **Instructions:** - Follow the prescribed doses. - Contact the healthcare provider if pain persists or worsens. - Schedule a follow-up consultation in 4-6 weeks to assess progress. - If symptoms of migraines or fibroadenoma worsen, further diagnostic tests (ultrasound, mammogram) may be necessary. - Avoid high-caffeine and alcohol intake. Dr Shayeque Reza MD Date- 12/04/25 9800280276

Hello Vandana, **Patient Information:** Name: [Your Name] Age: 20 years Sex: Female **Presenting Complaint:** The patient reports experiencing irregular periods that are often delayed, along with constant weight gain despite following a regular exercise routine and diet. She also experiences frequent bloating. The patient is concerned about her inability to manage weight effectively, despite healthy lifestyle habits. **Clinical History:** - Periods are delayed at times. - Significant weight gain over time, despite consistent efforts with diet and exercise. - Occasional bloating, which exacerbates discomfort. - No specific history of other chronic illnesses or major health concerns. **Possible Causes:** The patient’s symptoms suggest potential underlying conditions that could be contributing to her issues: 1. **Polycystic Ovary Syndrome (PCOS):** A common cause of irregular periods, weight gain, and bloating in young women. PCOS is characterized by hormonal imbalances, where higher levels of androgens (male hormones) can disrupt the menstrual cycle and lead to weight gain, particularly around the abdomen. Bloating is also a common symptom. 2. **Hypothyroidism (Thyroid Imbalance):** An underactive thyroid can lead to slowed metabolism, which causes difficulty in losing weight, weight gain, fatigue, delayed periods, and bloating. Hypothyroidism is a common cause of unexplained weight gain and menstrual irregularities. 3. **Insulin Resistance:** This often occurs with PCOS and can lead to difficulty losing weight, fatigue after meals, and bloating. Insulin resistance also affects how your body processes sugar and can cause cravings, making weight management more difficult. 4. **Stress and Sleep Disorders:** Chronic stress or poor sleep can disrupt the hormonal balance in the body, contributing to weight gain, delayed periods, and bloating. Stress impacts cortisol levels, which can lead to weight retention, particularly around the abdominal area. **Recommended Investigations:** To understand the root cause of the symptoms, the following tests should be considered: 1. **Thyroid Function Tests:** TSH, T3, T4 levels to rule out hypothyroidism. 2. **PCOS Testing:** LH, FSH, serum testosterone, and an ultrasound of the ovaries to check for cysts or other abnormalities indicative of PCOS. 3. **Fasting Insulin and Glucose Levels:** To assess insulin resistance. 4. **Complete Blood Count (CBC) and other routine investigations** to rule out any other potential causes. **Management Plan:** Based on the results of the above investigations, a treatment plan will be formulated, which may include hormonal treatments, dietary adjustments, insulin-sensitizing medications (if insulin resistance is present), and targeted exercise plans to manage weight and bloating. Stress management techniques, including mindfulness, relaxation exercises, or counseling, may also be beneficial. **Follow-Up:** A follow-up appointment will be necessary to review lab results and progress with any prescribed treatment. If any of the tests indicate a specific condition like PCOS or thyroid dysfunction, further referrals to a specialist may be recommended. Dr Shayeque Reza MD 9800280276

Patient Name: Neha Yadav Age: 30 years Date: [13/04/25] Chief Complaints: Prolonged bleeding (continuous menstruation) White, heavy discharge with a strong odor Itching and irritation in the intimate area Soaked clothes due to excessive discharge Diagnosis Considerations: Hormonal imbalance (e.g., PCOS, thyroid disorders) Vaginal infections (e.g., bacterial vaginosis, yeast infection) Uterine pathologies (e.g., fibroids, polyps) Vaginal hygiene concerns Treatment Plan: Blood Tests: Complete Blood Count (CBC) Thyroid function test (TSH, T3, T4) Hormonal profile (LH, FSH, estrogen, progesterone) Glucose levels (to check for diabetes) Ultrasound (Pelvic): To assess for any uterine abnormalities (fibroids, polyps, endometriosis, etc.) * Please do the test so that I can Plan your treatment * Follow up as soon as possible * Dr Shayeque Reza MD 9800280276

Hello Babli You’re carrying so much right now—physically, emotionally, hormonally. What you’re describing isn’t just random symptoms; it sounds like your body is waving red flags, asking for attention and support. Let’s gently break this down together and look at what might be going on, because there’s a strong possibility that it’s hormonal imbalance, maybe something like PCOS, thyroid issues, or even perimenopause, depending on your age. But regardless of labels, your experience is valid, and you deserve to feel better. Here’s what your body might be trying to say: 1. Weight gain (especially belly/thigh/waist) + bloating + joint pain These can point to hormonal imbalances (like insulin resistance, PCOS, or low thyroid). Feeling heavy even when not eating is often tied to inflammation, sluggish digestion, or hormonal water retention. 2. Low, brown/yellow period flow + irregular cycles This might suggest: Estrogen dominance (too much estrogen compared to progesterone) Perimenopause if you’re late 30s or 40s Thyroid dysfunction—hypothyroidism often causes light, irregular periods. 3. Headaches, nausea, fatigue, not able to eat These often come from gut issues, chronic stress, or again—hormones. Could also be linked to IBS or poor nutrient absorption (like low iron, B12, or magnesium). Things you can do now (gently, no pressure): 1. Get lab tests done if possible: If you’re up for it, ask your doctor to check: Thyroid panel (TSH, T3, T4, antibodies) Hormones (estrogen, progesterone, testosterone, LH, FSH) Vitamin D, B12, iron, CRP (inflammation) Insulin & fasting glucose Supportive things to do at home: Gentle movement daily (even stretching or walking)—helps joint pain, hormones, and digestion Warm, easy-to-digest meals (soups, stews, veggies + healthy fats + protein) Magnesium supplement (great for hormones, IBS, sleep, and joint pain) Stay hydrated, but avoid cold drinks—they can worsen bloating for some Got it! Based on everything you’ve shared—and since your periods are coming but the **flow is very low**, and you’re dealing with **hormonal imbalance, IBS, fatigue, joint pain, and vaginal boils**—here’s a **gentle daily routine with suggested medicines, supplements, and self-care practices** to help support your healing. --- ### **Daily Wellness Plan (Natural + Medical Support)** **(Feel free to screenshot or copy this)** --- ### **Morning (Empty stomach – after waking)** - **1 glass warm water** with a few drops of lemon (optional: pinch of turmeric) - **1 capsule: Myoinositol + D-Chiro Inositol** (e.g., Ovacare Myo / Normoz / OvaBoost) *Supports hormonal balance, weight, ovulation* --- ### **After Breakfast** - **Vitamin D3 + B12 + Iron supplement** *(e.g., Neurobion Forte + Shelcal-D or similar)* - **1 capsule Omega-3** (anti-inflammatory, supports joints and hormones) - **Probiotic capsule** (e.g., Darolac / VSL#3) *Supports gut, reduces IBS, improves immunity* **Breakfast Idea:** Warm khichdi, oats, poha with veggies, or eggs + toast *(Avoid cold/raw or heavy fried foods in the morning)* --- ### **Mid-morning (Optional)** - **Ashwagandha capsule or tea** (stress + hormone support) *(Skip if it worsens IBS)* --- ### **Lunch** - Warm, cooked meals—dal, rice, veggies, ghee, or roti + sabzi - Add **cumin + ajwain + ginger** in cooking to help digestion - Sit calmly during meals—no phone/stress eating --- ### **Post-Lunch** - **Liv52 tablet or syrup (Himalaya)** – supports liver, reduces bloating --- ### **Evening (Pre-dinner)** - **Peppermint tea or chamomile tea** – soothes digestion, helps calm mind - **Gentle walk or light stretching** – improves digestion, relieves joint tension --- # **Dinner** - Light meal – soup, khichdi, steamed veggies + moong dal *(Avoid cold drinks, heavy spices, sugar)* ### **Night (Before Bed)** - **Magnesium glycinate or citrate** supplement (relaxes muscles, eases sleep, supports digestion + headaches) - **Warm compress** on belly or joints if pain or bloating - **1–2 Himalaya Evecare capsules** *(regulates hormones, supports menstrual flow)* **Optional:** - Body scan meditation or deep breathing to quiet thoughts - Keep lights dim and phone off 30 mins before bed ### **Bonus Tips:** - Track your cycle, mood, and symptoms daily (can help your doctor too) - Drink warm water through the day, not cold - Try not to skip meals—it can worsen hormones and IBS This plan is **a supportive base**, not a cure—but many women see improvement in energy, flow, digestion, and mood over 2–3 cycles with this kind of care. If you're okay with it, I can also help write a message you can take to a gynecologist or general physician to ask for blood tests or confirm these meds. Want that? And if there’s one symptom that’s bothering you the most *right now* (like nausea or pain), I can suggest more targeted relief too.

when was the last time you got your period?

Hello Kaur, Don’t worry I can understand your problem, and I am here to help you out. Patient Name: Vishaldeep Kaur Age: 26 years Date: 12-April-2025 Chief Complaints: Irregular periods with short duration (2 days), delayed cycles, recent UTI, vitamin D deficiency, occasional stress. Concerned about possible PCOS/PCOD Clinical Impression: The pattern of short and delayed periods, coupled with general fatigue (likely from vitamin D deficiency) and occasional stress, may point toward a mild hormonal imbalance, but this alone doesn’t confirm PCOS or PCOD. Menstrual irregularity can be due to multiple causes, including: Functional Hypothalamic Dysfunction – Caused by stress, irregular sleep, or nutrition imbalances. PCOS/PCOD – Diagnosed by symptoms (irregular cycles, acne, weight gain, excess facial/body hair, hair thinning) and confirmed by ultrasound and hormone profile. Post-infection or temporary disruption – Recent UTI or any systemic illness can affect your cycle for a short term. Suggested Diagnostic Workup: To evaluate for PCOS or hormonal imbalance, the following tests are recommended: Pelvic ultrasound – To check for polycystic ovaries Hormonal Profile: LH, FSH (Day 2–5 of your cycle) TSH (thyroid) Prolactin AMH (Anti-Mullerian Hormone) Testosterone (Total and Free) Vitamin D level – If not recently repeated CBC and CRP – To rule out low-grade inflammation Management & Advice: Vitamin D correction: Tab. D3 must 60,000 IU – once weekly for 6 weeks (under guidance) Sunlight exposure 15–20 mins/day Menstrual regulation: Track your cycles using an app or calendar Consider low-dose OCP or cyclical progesterone (only after proper evaluation if PCOS confirmed) Lifestyle Modifications: Regular physical activity (brisk walk/yoga 30 min/day) Balanced diet with more protein, fiber, and healthy fats Reduce processed sugar and refined carbs Manage stress through mindfulness/meditation If periods remain irregular for more than 3 months, a gynecologist/endocrinologist consultation is advised for tailored hormonal therapy. Conclusion: It is too early to confirm PCOS based on just delayed or 2-day periods. A proper diagnostic workup is needed. Your current symptoms could be due to temporary stress, nutrient deficiency, or minor hormonal fluctuation. With a few tests and lifestyle care, things can be improved significantly. *Follow Up with reports* Dr Shayeque Reza MD 9800280276

In PCOS there is delayed periods. You can wait for 45 days from your last period.

Patient Name: Kajal Age: 22 years Date: 12-April-2025 Chief Concern: Delayed menstruation – Last period in mid-February; no period in March or April (until 12th); pregnancy test on 8th April was negative. No current stress. Clinical Impression: A missed or delayed period in an otherwise healthy young woman can occur for several reasons other than pregnancy—especially if your pregnancy test was negative after a reasonable window. Since you're not under stress, some possible explanations include: Anovulation (absence of ovulation during a cycle): This can occur occasionally even in women with regular cycles. Hormonal fluctuations: Thyroid dysfunction, elevated prolactin levels, or mild PCOS can cause delayed ovulation or skipped periods. Weight changes: Even without noticeable gain/loss, small shifts in diet, physical activity, or body fat percentage can affect menstrual hormones. Post-viral or immune response: Sometimes, a recent viral illness or minor systemic imbalance can disrupt the cycle temporarily. Medication or supplement use (if any): Certain drugs or supplements can interfere with hormonal balance. Advice & Recommendations: Repeat pregnancy test around 14th April to rule out late implantation. If still negative and no periods by 20th April, consider consulting a gynecologist. They may advise: Hormonal blood tests: TSH, Prolactin, LH, FSH Pelvic ultrasound: To check ovarian function and uterine lining Lifestyle check: Ensure consistent sleep patterns and regular meals Avoid over-exercising or undereating If periods still don’t resume, a short course of hormonal medication may be prescribed to induce withdrawal bleeding — but only after evaluation. Conclusion: One skipped period without other symptoms is usually not a serious issue. However, if your cycle becomes consistently irregular, it’s advisable to look deeper into hormonal health. For now, monitor your symptoms, stay hydrated, maintain a balanced routine, and recheck your pregnancy test if needed. Do let me know if you need paid consultation. Dr Shayeque Reza MD 9800280276

Patient Name: Harman Age: 25 years Gravida: G2 (Second Pregnancy) Gestational Age: 26 Weeks Date: 12-April-2025 Chronic Illnesses: None reported Chief Concern: Mild nosebleeds during the 26th week of pregnancy. Concerned if this is normal and whether any other changes should be expected in this stage. Clinical Impression: At 26 weeks of pregnancy, several physiological changes occur in the body due to increased blood volume and hormonal influence. Mild nosebleeds (epistaxis) are common and usually harmless in pregnancy, especially in the second and third trimesters. This happens due to: Increased blood flow and vessel sensitivity – Pregnancy hormones like estrogen and progesterone increase blood flow to mucous membranes, making nasal blood vessels more fragile. Dry nasal passages – Often caused by weather changes, air conditioning, or dehydration, which can worsen nosebleeds. Minor trauma – Like nose picking or blowing the nose too hard. Advice and Reassurance: Stay hydrated – Drink plenty of water to keep mucous membranes moist. Use a saline nasal spray – Keeps nasal passages moist and reduces dryness-related bleeding. Humidifier at night – Helps prevent dryness from indoor air. Avoid blowing nose forcefully or picking nose. Cold compress on the nose bridge during bleeding episodes helps constrict vessels. Sleep in a slightly elevated position to reduce nasal pressure. Warning Signs (When to Seek Medical Attention): Frequent or heavy nosebleeds Bleeding that doesn’t stop after 10–15 minutes of applying pressure Bleeding with high blood pressure, dizziness, or vision changes Any signs of anemia (excessive tiredness, pale skin, breathlessness) Other Common Changes at 26 Weeks: Baby's movements become more regular and stronger Backache or pelvic discomfort Leg cramps or mild swelling in feet Increased heartburn or constipation Emotional mood swings or vivid dreams Next Steps: Continue prenatal vitamins (Iron, Calcium, Folic Acid) Maintain left-side sleeping position Monitor fetal movements daily Attend regular antenatal check-ups Optional: Blood pressure check and hemoglobin level (to rule out anemia if bleeding is frequent) You are doing great. Don’t worry mild bleeding is normal. Please rate and review. For consultation do reach me. Dr Shayeque Reza MD 9800280276